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November 2007

Exercise Training Program in Children and Adolescents With Cerebral Palsy: A Randomized Controlled Trial

Author Affiliations

Author Affiliations: Rehabilitation Centre “De Hoogstraat” (Mr Verschuren and Drs Ketelaar and Gorter), Department of Pediatric Physical Therapy and Exercise Physiology, University Hospital for Children and Youth “Het Wilhelmina Kinderziekenhuis” (Mr Verschuren and Drs Helders and Takken), and Rudolf Magnus Institute of Neuroscience (Drs Ketelaar and Gorter), University Medical Center Utrecht, Partner of Netchild, Network for Childhood Disability Research (Mr Verschuren and Drs Ketelaar and Gorter), and Julius Centre for Health Sciences and Primary Care (Dr Uiterwaal), Utrecht, the Netherlands.

Arch Pediatr Adolesc Med. 2007;161(11):1075-1081. doi:10.1001/archpedi.161.4.356

Objective  To evaluate the effects of an 8-month training program with standardized exercises on aerobic and anaerobic capacity in children and adolescents with cerebral palsy.

Design  Pragmatic randomized controlled clinical trial with blinded outcome evaluation between July 2005 and October 2006.

Setting  Participants were recruited from 4 schools for special education in the Netherlands.

Participants  A total of 86 children with cerebral palsy (aged 7-18 years) classified at Gross Motor Function Classification System level I or II.

Intervention  Participants were randomly assigned to either the training group (n = 32) or the control group (n = 33). The training group met twice per week for 45 minutes to circuit train in a group format that focused on aerobic and anaerobic exercises.

Main Outcome Measures  Aerobic capacity was assessed by the 10-m shuttle run test, and anaerobic capacity was assessed by the Muscle Power Sprint Test. Secondary outcome measures included agility, muscle strength, self-competence, gross motor function, participation level, and health-related quality of life.

Results  A significant training effect was found for aerobic (P < .001) and anaerobic capacity (P = .004). A significant effect was also found for agility (P < .001), muscle strength (P < .001), and athletic competence (P = .005). The intensity of participation showed a similar effect for formal (P < .001), overall (P = .002), physical (P = .005), and skilled-based activities (P < .001). On the health-related quality of life measure, a significant improvement was found for the motor (P = .001), autonomy (P = .02), and cognition (P = .04) domains.

Conclusions  An exercise training program improves physical fitness, participation level, and quality of life in children with cerebral palsy when added to standard care.

Trial Registration  isrctn.org Identifier: ISRCTN77274716